MEDICARE: LONGS DRUG STORES CALIFORNIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PHY49516	CA
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0512447	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134162498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONGS DRUG STORES CALIFORNIA LLC

Provider Business Mailing Address
First Line	:	1 CVS DR
Second Line	:	P.O. BOX 1075
City	:	WOONSOCKET
State	:	RI
Zip	:	02895-6146
Country	:	US
Telephone Number	:	401-765-1500
Fax Number	:	401-770-7108

Provider Business Practice Location Address
First Line	:	150 S MAIN ST
Second Line	:
City	:	FORT BRAGG
State	:	CA
Zip	:	95437-4205
Country	:	US
Telephone Number	:	707-961-0464
Fax Number	:	707-961-0460

Authorized Official
Title or Position	:	DIRECTOR, PAYER RELATIONS
Name	:	SUSAN COLBERT
Credential	:
Telephone Number	:	401-770-2751

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	03/02/2012

Similar Medicare Providers

1174070890 — MR. HSIN CHIEH KUO PHARMD
Practice Location Address:

150 S MAIN ST
FORT BRAGG, CA
95437-4205

Practice Phone: 707-961-0464
Practice Fax: 707-961-0460

1639646557 — PETER JAMES ECONOMEN PHARMD
Practice Location Address:

150 S MAIN ST
FORT BRAGG, CA
95437-4205

Practice Phone: 707-961-0464
Practice Fax:

1104578632 — RAHAF KHZAM
Practice Location Address:

150 S MAIN ST
FORT BRAGG, CA
95437-4205

Practice Phone: 707-961-1342
Practice Fax:

1689273278 — MAELENE KAY SCHUHMACHER-OMAR APRN
Practice Location Address:

303 COLLAND DR
FORT COLLINS, CO
80525-4205

Practice Phone: 970-821-3031
Practice Fax:

1417880147 — THE MILK MIND LLC
Practice Location Address:

9308 BECKETT LN APT 4205
FORT WORTH, TX
76123-2246

Practice Phone: 718-207-5110
Practice Fax:

1750364931 — SCOTT J SCHAFFER MD
Practice Location Address:

303 COLLAND DR
FORT COLLINS, CO
80525-4205

Practice Phone: 970-461-8031
Practice Fax: 970-461-8932

Directions to “LONGS DRUG STORES CALIFORNIA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.